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School

University of Guelph

Department

Psychology

Course

PSYC 3850

Professor

Online Class

Semester

Fall

Description

Intellectual Disabilities
CHAPTER 1: Understanding Intellectual Disabilities
• There is arrange of variability that is considered “normal”
o Outside this range, differences are often extreme enough to attract attention
• Some developmental differences may be so subtle at one point in time that they don’t
attract attention but may become more evident at another time in the developmental
lifespan
• What may be considered a developmental limitation by one profession at one time, may
be viewed otherwise by another profession at another time
Historical Perspectives
- Societies throughout the ages have been affected by intellectual disabilities, although
the way people have viewed those having this condition has changed significantly over
time
- Many diverse concepts and varying characteristics have influenced different descriptions
of people with intellectual disabilities, depending on society’s views and situational
influences during any given time period
- The concept of intellectual disabilities has been fluid and elusive for a variety of reasons,
not the least of which have been the influences of economic, social and political climates
of various cultures throughout history
- Before 1800 having intellectual disabilities was not considered an urgent social problem
in any society because those with more severe intellectual disabilities were either killed
or died of natural causes at an early age
o In some cases, those with disabilities were viewed as a drain on society and
targeted for elimination, even in relatively recent times such as the mid-1900s
- The earliest written reference to intellectual disabilities is dated 1552 BC - Human skulls dating to the Neolithic age indicate crude brain surgeries were performed
– surgical procedures apparently were intended to cure abnormal behaviour; methods
may have been based on the assumption that evil spirits caused strange behaviour and
that opening a hole in the skull permitted them to escape
o Regardless of the reason for these surgeries, the treatment often resulted in
behaviour resembling diminished intellectual ability
- Socioeconomic conditions have influenced human understanding and treatment of
people with intellectual disabilities
o Primitive tribes often looked on mental and physical differences with fear or as
signs of disgrace because of the stigma associated with such conditions
o Those with disabilities often represented an unbearable economic drain on the
tribe – nomadic tribes couldn’t afford to be burdened by members who consumed
limited food and water supplies but did not tangibly contribute to the common
welfare
o Those with intellectual disabilities were viewed as a wasteful extravagance the
group could not afford
- Throughout history, political authority has also been a force in determining the lot of
people with intellectual disabilities – sometimes authority supported harsh treatment of
individuals with disabilities, while at other times more humane approaches were in favor
- Individuals with intellectual disabilities and those with other disability conditions have
long been at the mercy of the more able majority
- Neither religious nor economic perspective was conducive to the care of those with
intellectual disabilities
- Reproductive sterilization has periodically been a topic in the history of intellectual
disabilities
o Sterilization issue has been entangled with a number of other questions: nature-
vs-nurture dispute, political and economic issues and moral and social debates o Some early genealogical studies were very influential at generating the
sterilization controversy in the US
 Henry Goddard (1913) – traced decedents of a Revolutionary War soldier
to whom he gave the pseudonym Martin Kallikak
 Kallikak had sexual relations with a barmaid and fathered a child and
decedents of this union were reported to be primarily thieves, prostitutes,
and other social undesirables
 He later married a “normal” woman and their decedents were purportedly
normal and in some cases, superior
 Resulting conclusion was that because of genetics, one group was
doomed to a life of degeneracy, while the other was almost certainly
destined to be successful
- Godder’s report fostered a sterilization movement in the early part of the 20 century
- Fear of intellectual disabilities promoted widespread support for the methods that would
“control” it, among them sterilization and isolation
- Institutions became custodial to protect society and prevent reproduction
DISCIPLINES AND PROFESSIONS
Disciplinary Perspectives and Contributions
- In many ways, people with intellectual disabilities are similar to the individuals without
disabilities – their need for love, independence, support and respect is the same as
everyone else’s and everyone benefits from the service contributions of such
professions as medicine, education, psychology, sociology etc., although those with
intellectual disabilities will likely benefit to an even greater degree
- There are multiple professions involved in the field of intellectual disabilities – the
delivery of services and understanding of individuals with intellectual disabilities are far
beyond the scope of any single discipline - Communication and collaboration are crucial for professionals in all disciplines –
communication process depends on building trust and being committed to information
sharing as well as improving the child’s program
Terminology
- From characterizing intellectual disabilities as a genetically determined and incurable
condition, professionals have moved toward a more fluid conceptualization that includes
biomedical causes, as well as environmental and social factors in determining whether
someone has or does not have intellectual disabilities at a given time
- The term “intellectual disabilities” includes a wide range of behaviour – it shares with
other such “people-labeling terms” the attribute of being a convenient, generalized
expression about persons of groups
- Intellectual disabilities is both a label of fact and a label of conjecture (an opinion or
conclusion formed on the basis of incomplete information)
o A label of fact must be quantifiable and verifiable (as a label of fact, intellectual
disabilities must demonstrate observed characteristics that are verifiable and
quantifiable, perhaps determined by a biomedical diagnosis)
o A label of conjecture may include concepts that are as yet only hypothesized
- Only about 20% of intellectual disabilities is caused by biomedical factors and for the
remaining 80%, the actual cause is uncertain, therefore, intellectual disabilities is also a
label of conjecture
- Incidence of milder forms of intellectual disabilities is much higher for people from lower
socioeconomic backgrounds
- The orientation of a discipline affects its view of people with intellectual disabilities
o Each discipline, at least initially, sees a person with intellectual disabilities from its
own perspective but such a view should not preclude different professions from
at least being aware of and appreciating the contributions of their colleagues in
related areas - Tools (e.g. IT) are only as helpful as the people that use them – the focus must be on the
core issues and problems to be solved, not on the technology itself
Contributions of Biological and Medical Sciences
- An intellectual disability as a label of fact is best exemplified as most frequently related
to a biomedical cause, however, even when the condition if readily identifiable, the cause
is not always clear
- Medical professional have long been involved with intellectual disabilities in a number of
ways
o A physician is frequently the first professional to identify, diagnose and counsel
parents of children with intellectual disabilities
- It is not unusual for physicians to view intellectual disabilities from a physiological
perspective – physicians frequently have not had sufficient background to understand
the nonmedical ramifications of this condition; this limited view may limit their
effectiveness in working with a family
- Medical research is another important area of medicine that warrants attention
o Advances in medical research have had a dramatic impact in several areas
related to intellectual disabilities
o It has become possible to implement procedures that prevent some forms of
intellectual disabilities but to reach this point, interdisciplinary collaboration was
required
- Advances in genetics have opened avenues that will allow professionals to prevent
many forms of intellectual disabilities
o At present, some forms of intellectual disabilities are preventable before
conception (e.g. genetic screening)
Contributions of the Behavioural Sciences
- Although behavioural sciences have made important contributions to the understanding
and treatment of intellectual disabilities, most have dealt with it in only a limited fashion, and each field generally has operated independently and within the confines of its own
terminology and parameters – the consequent reduction in effective contributions to
education about and treatment of intellectual disabilities exemplifies the importance of
interdisciplinary collaboration
- Psychology has been the behavioural science most directly involved in the scientific
study of intellectual disabilities
- 3 important areas to which psychology has contributed are:
a) Intelligence theory and testing
b) Learning theory research
c) Interpersonal social aspects
- Historically, anthropology has focused relatively little attention on intellectual disabilities,
yet it has offered some extremely important insights into the broader perspective of the
condition
o Early work by Edgerton (1968) described the anthropological study of intellectual
disabilities as nonexistent and argued for drastically expanded efforts –
Edgerton’s continued effort represents important anthropological contributions
and has added considerable information about the adaption of people with
intellectual disabilities to their environments
- Anthropology offers some intriguing possibilities from the standpoint of research
methodology
o The major anthropological approach to research represents qualitative research
methods, emphasizing observation and recording of information about people in
their environment – this is a substantially different approach from that historically
used in the study of intellectual disabilities
- Anthropology is a discipline that has not been broadly involved in intellectual disabilities
but one that may make substantial contributions in an interdisciplinary effort
- Sociology has been investigating intellectual disabilities, at least tangentially, for years o A number of authors have examined disabilities from sociological perspectives
and concepts of social competence and deviance – in many cases, authors
discuss the need to view disabilities from a sociological perspective rather than
from the traditional clinical model
o The full contribution of sociology to the understanding of intellectual disabilities in
a larger societal framework remains untapped
- The law has also been an important force in the area of intellectual disabilities – the legal
profession, in comparison to other professions, tends to operate in an adversarial role
Contributions of Education
- Educators do not have the luxury of viewing the world from a restricted framework or
retreating behind disciplinary fences when faced with the multidisciplinary needs of those
with intellectual disabilities
- The role of education in intellectual disabilities is one of providing effective research-
based instruction
- The contributions of education in aiding the understanding of intellectual disabilities has
been to:
a) Identify needs
b) Stimulate research and theory
c) Coordinate and deliver instruction and related services
- Identifying children with intellectual disabilities was one of the earliest efforts of
education
o First intelligence test worthy of the name was developed by Alfred Binet
o Task was to develop a way to determine which children are likely to fail in school
programs and need special help; therefore, the measurement of intelligence has
been influenced by educational needs, rather than by the interests of the
discipline - Social factors were also important in determining a child’s present and future
performance levels – professionals have since been introduced to the concepts of
adaptive behaviour and social intelligence
- The need to understand mild intellectual disabilities has influenced research efforts to
increase knowledge about the importance of environmental influences on intelligence
- The development of secondary school programs has created a need for appropriate
curricula and has prompted research on many different factors related to community
placement for adolescents and young adults with intellectual disabilities
- Educators stimulate the efforts of disciplines and then using their findings for the
betterment of society
Disciplinary Collaboration
- It is evident that isolated efforts within a profession, without interdisciplinary
collaboration, often result in less effective service delivery to people with intellectual
disabilities
- The different professions are making progress toward bridging the gaps among their
perspectives; at least two factors have prompted this progress:
o Experience has shown that people with intellectual disabilities being served are
the ultimate beneficiaries of improved cooperation
o The realization that something can be done to promote interdisciplinary
collaboration
- When knowledge is limited to a single field, differences in perspective result
- The acquisition of enough information to understand another perspective broadens
professional viewpoints and focuses efforts on the person needing service
- Beyond the professional and discipline level, similar cooperative efforts are essential in
state service and political arenas
- Interdisciplinary cooperation is also important at the practitioner level – the contact point
between the service-delivery system and the person with intellectual disabilities - Inclusion: an educational placement approach for children with disabilities that involves
educating a significant number of such children in general education classrooms
o When this has been accomplished properly, it has been based on a thorough
functional analysis of the child’s skills and abilities along with an examination of
the curriculum, personnel, and other elements present in the classroom
Intellectual Disabilities as a Concept
- Over the years, definitions have encountered difficulties trying to incorporate advances
in conceptual understanding and social progress while attempting to maintain
measurement usefulness and accuracy
- Clarifying the concept of intellectual disabilities has become more complex as previously
unknown factors are taken into account
- Intellectual disabilities always implies reduced level of intellectual capacity and the
concept of intelligence has played a central role in defining intellectual disabilities
o Every controversy about the nature of intelligence has a direct impact on the field
of intellectual disabilities, thus part of the difficulty in defining intellectual
disabilities relates to the notion of performance and measurement of intelligence
- Social competence has been an important element of most recent definitions of
intellectual disabilities
- Intellectual disabilities has always been an area of interest and study for many
professions and this has also contributed to the challenges of definitional and conceptual
clarity
o The various definitions and classification systems of these disciplines tend to
focus on the constructs of a particular profession rather than on the affected
individual
o Sociologists set out to study intellectual disabilities as a social challenge,
psychologists examine it as a psychological condition, physicians treat it as a
medical condition etc. - Intellectual disabilities need to be examined from a multidisciplinary perspective, while
still focusing attention on the individual at hand
- Preparation of professionals who work with those having intellectual disabilities has been
hampered by definitional issues – education and training is much more difficult in the
absence of a concept of intellectual disabilities that is logical, theoretically sound and yet
functional in field settings
- Individuals with intellectual disabilities must be viewed as developing human beings with
varying needs and characteristics, living in a fluid and complex society
- Human development is an excellent framework for examining intellectual disabilities – it
serves effectively across disciplines, causes, and the full range of human life
Intellectual Disabilities: A Definition in Transition
- Definitions of intellectual disabilities have varied widely over the years among disciplines
- The definition of intellectual disabilities is currently in a transition period
- Similarly, the language being employed is evolving with different descriptions of this
complex condition
- The American Association on Mental Retardation (AAMR) definition of “intellectual
disabilities” is:
“Mental retardation is a disability characterized by significant limitations both in
intellectual functioning and in adaptive behaviour as expressed in conceptual
social, and practical adaptive skills. This disability originates before age 18.”
o This definition provided by its assumptions (p.19-20), stress the functioning of a
person with intellectual disabilities within home, school and community
environments
- The importance of adaptive behaviour and inclusion in the community has been evident
in the intellectual disabilities literature
o However, the measurement of adaptive behaviour has always been a challenge,
not achieving the desired precision despite the significant and continuing
research efforts - Adaptive behaviour is a very important concept in the most recent AAMR definition
o Concerns about assessment accuracy continue, as do apprehensions regarding
implementation and growing evidence regarding overrepresented ethnic
minorities among those diagnosed with intellectual disabilities
o Response to these concerns is reflected in the narrative of the 2002 AAMR
definition – future implementation of this definition will determine the degree to
which it can be translated into effective action
- Individuals’ behaviors are considered adaptive to the degree they manage personal
needs, display social competence and avoid problem behaviors
- The AAMR definition focuses adaptive behaviour assessment by specifying that it be
“expressed in conceptual, social and practical adaptive skills”
- The manifestation of the adaptive behaviour skills emphasizes how well an individual
actually shows adaptation in the context of his or her environment – diagnosing an
individual as having intellectual disabilities using this definition means that the
assessment of adaptive behaviour must focus on the expression of adapting in practical
terms, which requires some significant assumptions about adaption and its
measurement (p.21)
- One perspective of a person with intellectual disabilities is a person who relies on some
protection and support from the family/community
o Two factors enter into this perception:
a) The deficits/level of functioning of the individual with intellectual
disabilities
b) Threshold of community tolerance
o The kind of action taken depends on the degree to which an individual deviates
significantly from community norms – from those zones of
behaviour/performance society deems acceptable
o The 2002 AAMR definition conceptualizes intellectual disabilities in this manner –
“in the context of his or her environment and the supports that are in place” - People with intellectual disabilities often come to the attention of someone in their
community because they act or look differently enough from the norm to be noticeable –
this is true regardless of the degree of disability
o Identification of the individual with a more severe disability may occur at birth or
very early in life – this identification usually happens because a physical or
behavioural anomaly is already evident at this stage of development
o For those who differ less obviously form the norm, identification may not occur
until they begin to develop language or enter school
- Recently, there has been an intense focus on the person with intellectual disabilities
within the community
o An organization known as TASH (formerly the Association for Persons with
Severe Handicaps) has developed advocacy position statements relating to life in
community settings and supports should be available for inclusive and integrated
life in the community
 Although these perspectives are based on philosophies of civil rights,
dignity and social justice, they are also aligned with human development
research that has emerged over the years
 TASH supports realistic life in the general community, inclusive and early
educational experiences, as well as promoting quality and best practices
in all services and the development of inclusive public policy on health
care matters
- Another organization working in intellectual disabilities is the IASSID (International
Association for the Scientific Study of Intellectual Disabilities)
o It reflects a perspective that emphasizes issues facing an individual within the
community
o These perspectives take the study of intellectual disabilities directly into the
community and emerge with some of the same issues facing all of us
Incidence and Prevalence - Incidence: refers to the number of new cases identified during a given time period (often
1 year)
o Tabulating (arranging in tabular form) incidence involves a count of all individuals
identified as having intellectual disabilities during that period, whether newborns
of youngsters diagnosed in school
- Prevalence: refers to all cases existing at a given time, including both newly identified
cases and cases still labeled as having intellectual disabilities from earlier diagnosis
- These two kinds of counting do not result in the same number, but the terms have often
been used rather loosely, sometimes interchangeably, in the literature – whenever
possible, incidence and prevalence are examined separately
- Inconsistent definition and classification schemas over the years have made the problem
of determining frequency of intellectual disabilities even more formidable, particularly
form a cross-cultural perspective and for those who have other disabilities that are co-
occurring
- Those with a more mild disability represent by far the largest proportion of the intellectual
disabilities population – Hardman et al (2006) estimated that about 0.75% of the total
population was mildly affected, which represents about 90% of those diagnosed as
having intellectual disabilities
- The 2002 AAMR definition does not employ a classification system regarding degree of
disability based on IQ level (mild, moderate, severe/profound), electing to focus on the
intensities of supports needed – the approach taken suggests varying levels of intensity
for the supports needed by an individual with intellectual disabilities
- Four intensity levels of supports are outlined in following manner:
a) Intermittent: supports are provided a